IMPACT Act aspects to 'trickle down' to Medicaid, expert predicts

Skilled nursing facilities should be on the lookout for aspects of the Improving Medicare Post-Acute Care Transformation Act of 2014 to trickle into the Medicaid world, one expert advised on Wednesday.

Although the IMPACT Act is still in its early stages of implementation, the evidence is there that some of its policies may be translated to Medicaid further down the road, said Julie Hamos, principal at Health Management Associates, during a policy session at the Post Acute Link Care Continuum Conference.

“I'm seeing the picture on the wall the same way that as with Medicare, how the readmissions policy started with Medicare but then trickled down to Medicaid,” Hamos told McKnight's. “I just saw this as ‘Why not?' Once there's a uniform assessment process, and some uniform cross-system metrics and processes, it makes sense to also translate [the policies] into Medicaid.”

Hamos suspects bundled payments may come to Medicaid as a “trickle down” process.

“So many people start in Medicare, and when they've depleted their assets, then they're in Medicaid,” Hamos said. “So we have a lot of SNFs in the Medicaid space and they have to operate in both. So SNFs especially should be mindful of those changes."

Hamos' sentiments were echoed earlier in the day during a session specifically dedicated to bundled payments, where experts urged skilled nursing providers to be aware of the opportunities bundled payments can offer them.

“This is an indication that the [Centers for Medicare & Medicaid Services] is serious,” shared David Terry, founder and CEO of Archway Health. “When they came out with the [joint replacement bundle] that was a big deal — it's here, it's here to stay, and it's coming in a bigger way.”

Nearly 600 post-acute care professionals from across the continuum are expected to gather during the Post Acute Link conference, which runs through Friday in Chicago.

Fecal transplants should be considered for patients with recurrent cases of Clostridium difficile whose symptoms cannot be addressed by antibiotics, the Infectious Diseases Society of America said in new guidelines published Thursday.

Lawmakers took a long-standing industry complaint to the Department of Health and Human Services this week, telling Secretary Alex Azar that Medicare and Medicaid favor opioid prescription over non-addictive alternatives for treating chronic pain.